Difference Between Medicaid and Community Medicaid

Last updated: September 03, 2019
Medicaid Long Term Care | Questions and AnswersCategory: OtherDifference Between Medicaid and Community Medicaid
Anonymous asked 5 years ago

What is the difference between Medicaid and Community Medicaid?

1 Answers
medicaidplanner Staff answered 5 years ago

The term, “Medicaid”, is a broad term, encompassing a variety of Medicaid programs for low income seniors, disabled persons, pregnant women, and children. However, within the “Medicaid” program there is Community Medicaid and Institutional Medicaid.

Community Medicaid refers to Medicaid benefits received in the home and community, or put differently, outside of an institution (i.e. nursing home facility). Relative to seniors, this includes benefits via Aged, Blind & Disabled (ABD) Medicaid. ABD Medicaid is for persons 65+ years old, blind or disabled, and covers physician appointments, wellness visits, hospital care, prescription drugs, laboratory services, prescription drugs, etc. Community Medicaid also encompasses long-term care in the home and community via HCBS (home and community based services) Medicaid Waivers. Examples of benefits via HCBS Medicaid Waivers include in-home personal care assistance and homemaker services, home modifications, adult day care, respite care, personal emergency response systems, assisted living services, and adult foster care.

Institutional Medicaid, on the other hand, is nursing home coverage. Via Institutional Medicaid, room and board, skilled nursing services, assistance with activities of daily living (bathing, personal hygiene, dressing / undressing, mobility, transitioning, incontinence, and eating), and therapies, such as physical and occupational therapy, are provided in nursing home facilities.

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